Newly Updated HIV Treatment Guidelines for Adults and Adolescents Available on the World Wide Web

An updated version of the Guidelines for the Use of Antiretroviral Agents in
HIV-Infected Adults and Adolescents has been posted to the HIV/AIDS
Treatment Information Service (ATIS) World Wide Web site, www.hivatis.org.

The Guidelines were developed by the Panel on Clinical Practices for the
Treatment of HIV Infection, a joint effort of the Department of Health and
Human Services and the Henry J. Kaiser Family Foundation. Initially
published in 1998, the Guidelines were constructed as a "living document"
and are updated frequently by the Panel as new data emerge.

"The number of treatment options for HIV-infected individuals has increased
dramatically, making decisions regarding therapy more and more complex,"
says Anthony S. Fauci, M.D., director of the National Institute of Allergy
and Infectious Diseases (NIAID) and co-chair of the Panel. "The new
Guidelines, based on the latest available research findings, provide
recommendations on how to optimally use the many antiretroviral medications
and sophisticated laboratory tests now available to people living with HIV."

The updated Guidelines are available at www.hivatis orgin two formats, a
typeset version (PDF) and a Web version (HTML). Single copies can be
ordered by calling 1-800-448-0440 (international callers may call
1-301-519-0459), or by sending an e-mail request to atis@hivatis.org.

The updated Guidelines include recommendations for the use in clinical
practice of recently developed tests that help determine if the virus a
patient is carrying has developed resistance to one or more antiretroviral
drugs.

"These tests can help to explain the reasons for treatment failure and guide
the rational selection of a new drug regimen," says John G. Bartlett, M.D.,
chief of the division of infectious diseases at the Johns Hopkins University
Medical Center and co-chair of the Panel. "The likelihood of reducing viral
load to undetectable levels is significantly increased when results of
resistance testing are available to guide the selection of a new drug
regimen for patients who are not doing well on their current regimens."

The updated Guidelines also contain a new section entitled The Goals of
Therapy. In addition to reiterating the goal of suppressing plasma viral
load to below detectable levels for as long as possible, the Guidelines
Panel recognizes that eradication of HIV infection is probably not possible
with currently available treatments and emphasizes the need to think
strategically about antiretroviral therapy.

In this regard, the updated Guidelines discuss other primary goals of
antiretroviral therapy, including 

restoration and/or preservation of the patient's
immunologic function

improvement of their quality of life

reduction of HIV-related illness and death.

The new Guidelines also delineate tools that may help achieve these goals,
including 

maximizing patient adherence to a regimen

selecting "user-friendly" regimens when possible

prescribing drugs in a rational sequence in order to
preserve future treatment options

utilizing drug resistance assays when treatment fails.

The Panel also has reorganized its recommendations for the use of
antiretroviral drugs in the initial therapy of HIV infection. Previously,
drugs were placed in the "Preferred" category on the basis of their ability
to suppress plasma viral load. In keeping with the newly elaborated goals
of therapy, considerations such as pill burden, dosing frequency, food
requirements, convenience, toxicity and drug interaction profiles underpin
the new recommendations.

The updated Guidelines' "Strongly Recommended" category now includes a
small number of drugs the Panel feels can accomplish many therapeutic goals
with minimal negative effects on an HIV-infected individual's quality of
life. Other potent drugs that can also suppress plasma viral load but do so
at a high cost to quality of life are now included under the heading
"Recommended as Alternatives."

Finally, a new hypertext link to detailed information on the use of
antiretroviral drugs in pregnant women has been added. This information
will help physicians select the most appropriate antiretroviral regimen for
their HIV-infected patients who are pregnant.

Co-conveners of the Panel on Clinical Practices for the Treatment of HIV
Infection are Eric Goosby, M.D., on behalf of the Department of Health and
Human Services, and Jennifer Kates, M.A, M.P.A., on behalf of the Henry J.
Kaiser Family Foundation. Oren J. Cohen, M.D., NIAID Assistant Director
for Medical Affairs, serves as the Panel's Executive Secretary.

NIAID is a component of the National Institutes of Health (NIH). NIAID
conducts and supports research to prevent, diagnose and treat illnesses such
as HIV disease and other sexually transmitted diseases, tuberculosis,
malaria, asthma and allergies. NIH is an agency of the U.S. Department of
Health and Human Services.

The Henry J. Kaiser Family Foundation, based in Menlo Park, CA, is an
independent philanthropy focusing on the major health care issues facing the
nation. The Foundation is not associated with Kaiser Permanente or Kaiser
Industries.